A Canberra neurosurgeon recently pulled a live, 8cm-long parasitic roundworm from the brain of her 64-year-old patient.
The New South Wales resident had first been admitted to a local hospital in late January 2021 after three weeks of abdominal pain and diarrhoea, followed by a constant dry cough, fever and night sweats, The Guardian reports.
By 2022, her symptoms also included forgetfulness and depression, prompting a referral to the Canberra hospital. An MRI scan of her brain revealed abnormalities requiring surgery.
However, said infectious diseases physician Dr Sanjaya Senanayake, colleague and neurosurgeon Dr Hari Priya Bandi “certainly didn’t go in there expecting to find a wriggling worm”.
“This was this was a once-in-a-career finding. No one was expecting to find that.”
The team scoured textbooks, looking up the different types of roundworm that could cause neurological invasion and disease, but when their search proved fruitless, they sent the worm, which was still alive, to the laboratory of a CSIRO (Commonwealth Scientific and Industrial Research Organisation) scientist experienced in parasites.
“He just looked at it and said, ‘Oh my goodness, this is Ophidascaris robertsi’,” said Senanayake.
Ophidascaris robertsi is a roundworm usually found in pythons. The Canberra hospital patient marks the world-first case of the parasite being found in humans.
The patient lives near a lake area inhabited by carpet pythons and often collected native grasses from around the lake to use in cooking.
The hypothesis is that a python may have shed the parasite via its faeces into the grass.
The doctors believe the patient was probably infected after touching the native grass and transferring the eggs to food or kitchen utensils, or after eating the greens.
Senanayake, who is also an infectious diseases expert based at the Australian National University, said the patient needed to be treated for other larvae that might have invaded other parts of her body, like the liver.
Care had to be taken as some medications might have triggered inflammation as the larvae died off. Inflammation can be harmful to organs such as the brain, so they also needed to administer drugs to counteract any dangerous side-effects.
The patient is recovering and the case has been documented in the September edition of the journal Emerging Infectious Diseases.
Senanayake said the world-first case highlighted the danger of diseases and infections passing from animals to humans, especially as people and animals start to live more closely together and habitats overlap more.
“There have been about 30 new infections in the world in the past 30 years,” he said. “Of the emerging infections globally, about 75% are zoonotic, meaning there has been transmission from the animal world to the human world. This includes coronaviruses.
“This Ophidascaris infection does not transmit between people, so this patient’s case won’t cause a pandemic like Covid-19 or Ebola. However, the snake and parasite are found in other parts of the world, so it is likely that other cases will be recognised in coming years in other countries.”
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